November 13, 2012

The Spanish Inquisition, Children With Diabetes and Surgery.

File this in the I wish I had know this better before folder. In my case that folder is a file cabinet but what the heck.

I didn't spend a ton of time thinking that the kids may need surgery. Health, active kids seem to have a myriad of issues most of which involved looking forward to school, sports, a camp, a play or some other interest. Typically we didn't think about them needing surgery.

Spending a few minutes thinking about it is would have been a solid idea. I am reminded of this by a great article with some useful links that I just read. I wish I had read it years ago: Pamela Wilson's, Surgery and Children with Diabetes.

Our experience has been that even routine dental surgery can wreck havoc on diabetes balance. One of the issues was steroids. They were routinely prescribed for recovery. They totally screw up Blood Glucose (BG) balance. How routine? Well so routine that even when we have had a agreed not to have them given to the kids, the post dental surgery process handed them out as a matter of course. The result was a festival of whacky BG that left the poor kid feeling a lot worse. His recovery to get back into the swing of things was significantly impared.

Not a lot of people expect appendicitis either. Should you happen to have a case of appendicitis and choose not to turn over BG management to the hospital, who in our case were going to change insulins and use a "sliding scale" they couldn't or maybe wouldn't define, you can expect the equivalent of the inquisition. Without the comfy chair.

I think the dental experience helped us anticipate the issues with the appendicitis. So maybe that file cabinet of things we learned the hard way payed off.

So here is today's YDMV school of hard knocks top tip: Next time you are at the endo have a conversation about, steroids, going off your regular insulin program and other emergencies medicine treatments. Prepare to advocate for your best interest when what is least expected happens.